Splinter Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A5383 Issued in CA

Legal business name

SPLINTER MEDICAL GROUP, INC.

Practice address

1334 W Covina Blvd
#103
San Dimas, CA 91773-3211

Phone

(909) 394-9090

Fax

(909) 394-9696

NPI assigned

Dec 12, 2005

Last updated

May 11, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. William Pevsner, D.O.NPI 1679758171

Title

President/Physician

Phone

(909) 394-9090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Jacob Pevsner, D.O.

  • Family Medicine Physician
  • San Dimas, CA
  • NPI 1679758171
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1629053723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 W COVINA BLVD",
            "address_2": "#103",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733211",
            "telephone_number": "909-394-9090",
            "fax_number": "909-394-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 W COVINA BLVD",
            "address_2": "#103",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733211",
            "telephone_number": "909-394-9090",
            "fax_number": "909-394-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPLINTER MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-12",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "PEVSNER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "909-394-9090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southern California Associated Neurologists Ipa Inc
• Alicia Sowah
• Julissa Sparks, LPCC, NCC
• Savannah Athena Sparks
• Spectrum Eyecare Optometry Inc
• Naiim Tysir Spratt
• Santi Srijumnong, PHARMD
• Julie Nicole Stassart, BA
• Christa Gerda Stefoni, MS CCC/SLP
• Leanne Marie Steinhaus, AMFT

• Family Medicine Physician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.